Individual provider Active NPI

Matthew R Mervis, M.D.

  • Obstetrics & Gynecology Physician
  • Orlando, FL
National Provider Identifier
1669476594
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME0049918 Issued in FL
Practice address
1111 S Orange Ave
4TH Floor
Orlando, FL 32806-1236
Phone
(407) 205-7646
Fax
(407) 264-7774
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME0049918 FL Primary

Addresses

Primary practice location

1111 S Orange Ave
4TH Floor
Orlando, FL 32806-1236

Mailing address

1111 S Orange Ave
4TH Floor
Orlando, FL 32806-1236
Phone (407) 205-7646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110519000431 FL Practitioner - Obstetrics/Gynecology 7517143993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Michigan Medical School, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Woman Care LLCGroup PAC ID 5395807218, 607 clinicians

Practice addresses (Care Compare)

1111 S Orange Ave
Suite 4
Orlando, FL 32806-1236
Phone (407) 649-4300

Merit-based Incentive Payment System (MIPS)

Final score
88.76 of 100Reported as group
Quality
84.84
Promoting interoperability
100
Improvement activities
40
Cost
77.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0049918FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Woman Care, LLC Obstetrics & Gynecology CurrentSince Mar 11, 2014 Accepting new patients
Womencare PA Past Accepting new patients

Locations

2815 S Seacrest Blvd
Ste 112
Boynton Beach, FL 33435
Phone (561) 368-0233

3000 Hunters Creek Blvd
Orlando, FL 32837
Phone (407) 337-8814

1111 S Orange Ave
Fl 4
Orlando, FL 32806
Phone (407) 205-7646

Interoperability endpoints

  • Direct secure messaging: matthew.mervis.1@2183.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1669476594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 S ORANGE AVE",
            "address_2": "4TH FLOOR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061236",
            "telephone_number": "407-205-7646",
            "fax_number": "407-264-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 S ORANGE AVE",
            "address_2": "4TH FLOOR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061236",
            "telephone_number": "407-205-7646",
            "fax_number": "407-264-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERVIS",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME0049918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.